Provider Demographics
NPI:1073921193
Name:DR. JEREMY SCHWARTZ DPM LLC
Entity Type:Organization
Organization Name:DR. JEREMY SCHWARTZ DPM LLC
Other - Org Name:COMPLETE FEET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PODIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-370-8362
Mailing Address - Street 1:3118 N SHEFFIELD AVE
Mailing Address - Street 2:#1S
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-8680
Mailing Address - Country:US
Mailing Address - Phone:847-370-8362
Mailing Address - Fax:
Practice Address - Street 1:525 W HAWTHORNE PL
Practice Address - Street 2:#3003
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-2907
Practice Address - Country:US
Practice Address - Phone:847-370-8362
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-01
Last Update Date:2014-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL016.005545261QP1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP1100XAmbulatory Health Care FacilitiesClinic/CenterPodiatric